Cough headaches

Your doctor may recommend brain-imaging tests, such as MRI or CT scans, to rule out other possible causes for your headaches.

• Magnetic resonance imaging (MRI). During an Magnetic resonance imaging (MRI), a magnetic field and radio waves are used to create cross-sectional images of the structures within your head to determine any problems that may be causing your cough headache.
• Computerized tomography (CT) scan. These scans use a computer to create cross-sectional images of your brain and head by combining images from an X-ray unit that rotates around your body.
• Lumbar puncture (spinal tap). Rarely, a spinal tap (lumbar puncture) may be recommended. During a spinal tap, the provider removes some of the fluid that surrounds your brain and spinal cord.

Treatment differs, depending on whether you have primary or secondary cough headaches.

Primary cough headache

If you have a history of primary cough headaches, your doctor may recommend that you take daily medication to help prevent or reduce the pain.

These preventive medications may include:

• Indomethacin (Indocin), an anti-inflammatory drug
• Propranolol (Inderal LA), a medication that relaxes blood vessels and reduces blood pressure
• Acetazolamide, a diuretic that reduces the amount of spinal fluid, which can reduce the pressure inside the skull

Other medications used to treat primary cough headache include methysergide, naproxen sodium (Aleve), methylergonovine, intravenous dihydroergotamine (D.H.E. 45) and phenelzine (Nardil).

Secondary cough headache

If you have secondary cough headaches, surgery is often needed to fix the underlying problem. Preventive medications usually don't help people who have secondary cough headaches. However, responding to medication doesn't necessarily mean that you have a primary cough headache.

You're likely to start by seeing your family doctor or a general practitioner. However, in some cases when you call to set up an appointment, you may be referred immediately to a neurologist.

Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and know what to expect from your doctor.

What you can do

• Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Write down key personal information, including past illnesses and operations, major stresses or recent life changes, recent accidents, details about what happened when the cough headache started, and any medical problems that run in your family.
• Make a list of all medications, vitamins and supplements that you're taking.
• Take a family member or friend along, if possible. Sometimes it can be difficult to remember all of the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to ask your provider.

Your time with your provider is limited, so preparing a list of questions will help you make the most of your time together. For cough headaches, some basic questions to ask include:

• What's the most likely cause of my headaches?
• Are there any other possible causes?
• What kinds of tests do I need?
• When will these headaches go away?
• What treatments are available?
• Are there any alternatives to the primary approach that you're suggesting?
• I have these other health conditions. How can I best manage these conditions together?
• Should I see a specialist?
• Is there a generic alternative to the medicine you're prescribing me?
• Are there any brochures or other printed material that I can take home with me? What websites do you recommend?

What to expect from your doctor

Your doctor or provider is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your provider may ask:

• When did you first begin experiencing cough headaches?
• Have your cough headaches been continuous or occasional?
• Have you had a similar problem in the past?
• Have you had other kinds of headache? If so, what were they like?
• Has anyone in your immediate family experienced migraines or cough headaches?
• What, if anything, seems to improve your headaches?
• What, if anything, makes your headaches worse?